| Gold Coast Medical P C | |
|
237 Jericho Turnpike Syosset NY 11791-4513 | |
| (516) 584-6400 | |
| (516) 584-6401 |
| Full Name | Gold Coast Medical P C |
|---|---|
| Speciality | Anesthesiology |
| Location | 237 Jericho Turnpike, Syosset, New York |
| Authorized Official Name and Position | Kostas Sideridis (OWNER) |
| Authorized Official Contact | 5165846400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gold Coast Medical P C P O Box 270 Massapequa Park NY 11762-0270 Ph: (631) 264-2035 | Gold Coast Medical P C 237 Jericho Turnpike Syosset NY 11791-4513 Ph: (516) 584-6400 |
| NPI Number | 1962752527 |
|---|---|
| Provider Enumeration Date | 09/11/2012 |
| Last Update Date | 05/14/2014 |
| Medicare PECOS PAC ID | 8820247703 |
|---|---|
| Medicare Enrollment ID | O20121009000794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962752527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (New York) | Secondary |
| 207L00000X | Anesthesiology | 220299 (New York) | Primary |
| Provider Name | Alison Choa |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922168251 PECOS PAC ID: 4688661036 Enrollment ID: I20040427001732 |
| Provider Name | Marci Malone |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487638029 PECOS PAC ID: 8921095183 Enrollment ID: I20040428001609 |
| Provider Name | Xiaochang Chen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619973625 PECOS PAC ID: 8527046952 Enrollment ID: I20040712000524 |
| Provider Name | Prabhakar R Veeramachaneni |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578597068 PECOS PAC ID: 4981675824 Enrollment ID: I20040804000128 |
| Provider Name | Raul J Masakayan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194706614 PECOS PAC ID: 4486601150 Enrollment ID: I20050405000588 |
| Provider Name | Zujin Li |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1902018161 PECOS PAC ID: 9133298763 Enrollment ID: I20080521000774 |
| Provider Name | Eva Chrysanthopoulos |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1972731016 PECOS PAC ID: 7416103262 Enrollment ID: I20120809000475 |
| Provider Name | Kamilla S Greenidge |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1740440767 PECOS PAC ID: 0345474615 Enrollment ID: I20130930000458 |
| Provider Name | Chetram Poonai |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851624233 PECOS PAC ID: 0446481931 Enrollment ID: I20140326001458 |
| Provider Name | Bo Feng |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1669672994 PECOS PAC ID: 1153472303 Enrollment ID: I20160318001124 |
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